Treatment of obesity by bilateral vagus nerve stimulation

• US 20040024428A1
• Filed: 07/01/2003
• Published: 02/05/2004
• Est. Priority Date: 07/01/1999
• Status: Active Grant

• Current Assignee: Burke Barrett, Mitchell S. Roslin, Ramish K. Reddy
• Original Assignee: Burke Barrett, Mitchell S. Roslin, Ramish K. Reddy
• Inventors: Roslin, Mitchell S., Barrett, Burke, Reddy, Ramish K.
• Granted Patent: US 7,299,091 B2
• Time in Patent Office: Days
• US Class Current: 607/58
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02

Abstract

A method of treating patients for compulsive overeating includes stimulating left and right branches of the patient'"'"'s vagus nerve simultaneously with electrical pulses in a predetermined sequence of a first period in which pulses are applied continuously, alternating with a second period in which no pulses are applied. The electrical pulses are preferably applied to the vagus nerve at a supradiaphragmatic location.

Claims

1. A method of treating patients for obesity, which comprises the steps of:

performing bilateral stimulation of the patient'"'"'s vagus nerve by applying a stimulating electrical signal to the right and left vagi, wherein the parameters of said signal are predetermined to produce a sensation of satiety in the patient.

2. The method of claim 1, including the step of applying said stimulating electrical signal intermittently to the right and left vagi.

3. The method of claim 2, wherein said intermittent application of said stimulating electrical signal is chronic.

4. The method of claim 1, including the step of applying said stimulating electrical signal continuously to the right and left vagi.

5. The method of claim 1, including the step of applying said stimulating electrical signal to the right and left vagi during a customary mealtime according to the patient'"'"'s circadian cycle.

6. The method of claim 1, including the step of applying said stimulating electrical signal to the right and left vagi upon delivery of an external commencement signal administered by the patient.

7. The method of claim 1, including the step of applying the same stimulating electrical signal to both the right and left vagi.

8. The method of claim 1, including the step of applying a different stimulating electrical signal to the right vagus from the stimulating electrical signal applied to the left vagus.

9. The method of claim 1, including using separate nerve stimulator generators for stimulating the left and right vagi.

10. The method of claim 9, including implanting said separate nerve stimulator generators into the patient.

11. The method of claim 1, including implanting nerve stimulator generator apparatus into the patient for said bilateral stimulation of the vagi.

12. The method of claim 1, including the step of applying said stimulating electrical signal supra diaphragmatically to the left and right vagi.

13. The method of claim 1, wherein said stimulating electrical signal is characterized by a current magnitude below a predetermined retching level.

14. The method of claim 1, wherein said stimulating electrical signal is a pulse signal having a prescribed on-off duty cycle.

15. The method of claim 14, including the step of applying said stimulating electrical signal continuously to the right and left vagi so that pulses are applied during the on portion of said duty cycle and not during the off portion of said duty cycle.

16. The method of claim 15, including using separate nerve stimulator generators for stimulating the left and right vagi.

17. The method of claim 15, including implanting separate nerve stimulator generators into the patient to stimulate the left and right vagi.

18. The method of claim 15, including the step of applying said stimulating electrical signal supra diaphragmatically to the left and right vagi.

19. The method of claim 15, wherein one of said parameters of said stimulating electrical signal is a pulse current magnitude below a predetermined level at which the signal tends to produce retching in the patient.

20. The method of claim 15, wherein said pulse signal has a pulse current magnitude in a range up to about 6 ma.

21. The method of claim 20, wherein said pulse signal has a pulse width in a range up to about 500 ms.

22. The method of claim 21, wherein said pulse signal has a repetition frequency of about 30 Hz.

23. The method of claim 22, wherein said pulse signal has a duty cycle with a ratio of on to off of about 1:

1.8.

36. The method of claim 1, wherein said electrical signal is applied synchronously to the right and left vagi.

37. The method of claim 1, wherein said electrical signal is applied asynchronously to the right and left vagi.

38. The method of claim 1, wherein said electrical signal is applied to the right and left vagi indirectly by stimulating the stomach or other visceral organ

24. A method of treating patients for compulsive overeating, which comprises the steps of:

stimulating left and right branches of the patient'"'"'s vagus nerve simultaneously with electrical pulses in a predetermined sequence of a first period in which pulses are applied continuously, alternating with a second period in which no pulses are applied.

25. The method of claim 24, including the step of applying said electrical pulses to the vagus nerve at a supradiaphragmatic location.

26. The method of claim 25, wherein said pulses have an electrical current magnitude not exceeding about 6 ma.

27. The method of claim 26, wherein said electrical current magnitude is preselected to be less than a level that induces retching in the patient.

28. The method of claim 27, wherein said pulses have a width not exceeding about 500 ms.

29. The method of claim 28, wherein said pulses have a repetition frequency of about 30 Hz.

30. The method of claim 29, wherein said second period is 1.8 times as long as said first period.

31. Apparatus for treating patients suffering from compulsive eating disorder, comprising:

implantable neurostimulator device means for simultaneously stimulating left and right branches of the patient'"'"'s vagus nerve with electrical pulses in a predetermined sequence of a first period in which pulses are applied continuously, alternating with a second period in which no pulses are applied; and

electrode means for implantation on said right and left branches in a supradiaphragmatic position.

32. The apparatus of claim 31, wherein said neurostimulator device means generates pulses with an adjustable electrical current magnitude not exceeding about 6 ma.

33. The apparatus of claim 32, wherein said neurostimulator device means generates pulses having an adjustable width not exceeding about 500 ms.

34. The apparatus of claim 33, wherein said neurostimulator device means generates pulses at a repetition frequency of about 30 Hz.

35. The method of claim 34, wherein said second period is adjusted to be 1.8 times as long as said first period.